Respiratory Cases II

21 yo male with dyspnea

Patient Chart
RC is a 21-year-old male who presents to the emergency department with increased temperature and dyspnea. He has a pulse of 106, respiratory rate 32, temperature 102.1o F. SpO2 on room air is 87%. He has a frequent cough productive of moderate amounts of very thick, dark yellow mucus. He appears to be underweight for his age. Upon questioning, he indicates that he has a history of cystic fibrosis.

Use the Auscultation and Blood Pressure tabs for blood pressure and lung sounds.

Portable chest radiograph shows infiltrates throughout both lung fields. Arterial blood gases drawn while the patient was receiving oxygen via nasal cannula running at 2 Lpm shows:

pH 7.36
PaCO2 56 mmHg
HCO3 31 mEq
PaO2 64 mmHg
SaO2 92%
Hgb 15.4 gms

Heart Rate:
Blood Pressure: /


Which of the following is this patient’s most likely diagnosis at this time?